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Khobkhun F, Srivanitchapoom P, Thanakamchokchai J, Richards J. The effect of a home-based exercise program on gait characteristics in an individual with Parkinson's disease over a one-year period: A case study. J Bodyw Mov Ther 2024; 39:512-517. [PMID: 38876677 DOI: 10.1016/j.jbmt.2024.03.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 02/29/2024] [Accepted: 03/13/2024] [Indexed: 06/16/2024]
Abstract
BACKGROUND The COVID-19 pandemic has placed a restriction on physiotherapy clinical visits for supervised exercise. It is important that individuals with Parkinson's Disease (PD) continue an exercise regime at home during the pandemic and also in normal situations. OBJECTIVE The purpose of this study was to explore the case history of an individual with PD who used a developed home-based exercise programme for one year during the COVID-19 pandemic. METHODS A 67 year-old married woman was diagnosed with PD stage 2.5 on the modified Hoehn and Yahr (HY) scale. Gait characteristics and the Movement Disorders Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS) motor scores were assessed at baseline, 10 weeks, and 12 months. The home-based exercise program included breathing exercises, posture correction, stretching exercises, rotation of the axial segments, balance training, and task-specific gait training. RESULTS After 12 months, her MDS-UPDRS motor scores decreased when compared to baseline and 10 weeks, and gait characteristics at 12 months showed an increase in the degree of foot rotation, step length, cadence, and gait speed when compared to baseline and 10 weeks. CONCLUSION This case study showed that improvements in MDS-UPDRS and gait characteristics can continue over a 12 month period as a result of a home-based exercise programme. Therefore, home-based exercise programs should be encouraged with weekly monitoring, especially in individuals with gait disorders which show deterioration.
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Affiliation(s)
- Fuengfa Khobkhun
- Parkinson Movement and Research Collaboration Laboratory, Faculty of Physical Therapy, Mahidol University, Salaya, Nakorn Pathom, Thailand.
| | - Prachaya Srivanitchapoom
- Division of Neurology, Department of Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Jenjira Thanakamchokchai
- Parkinson Movement and Research Collaboration Laboratory, Faculty of Physical Therapy, Mahidol University, Salaya, Nakorn Pathom, Thailand
| | - Jim Richards
- Allied Health Research Unit, University of Central Lancashire, Preston, UK
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Gao X, Zhang H, Fu X, Yang Y, Dou J. The effect of home-based exercise on motor and non-motor symptoms with Parkinson's disease patients: A systematic review and network meta-analysis. J Clin Nurs 2024; 33:2755-2774. [PMID: 38661119 DOI: 10.1111/jocn.17136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 01/23/2024] [Accepted: 03/14/2024] [Indexed: 04/26/2024]
Abstract
OBJECTIVE To evaluate the effects of home-based exercise in Parkinson's disease (PD) patients. DESIGN A network meta-analysis of randomized controlled trials. METHODS This study systematically searched PubMed, MEDLINE, Embase, Cochrane library and Web of Science. The quality of the literature was assessed using the Cochrane Risk of Bias 2.0 criteria. The data were pooled using R software. Results are presented as pooled standardized mean difference (SMD) with 95% confidence interval (CI). RESULTS Thirty studies involving 2264 PD patients were included. Meta-analysis results showed that home-based exercise had a small effect in relieving overall motor symptoms in PD patients (SMD: -.28, 95% Crl [-.43; -.14]), improving quality of life (SMD = .15 [.03, .26]), walking speed (SMD = .30 [.04, .56]), balance ability (SMD = .18 [.04, .33]; p < .0001) and finger dexterity (SMD = .28 [.10, .46]). Mixed exercise (Mix) had better effects on improving motor symptoms and quality of life. In addition, the results of dose analysis showed that only mixed exercise exceeding 850 METs-min per week and more than 18 weeks can significantly alleviate the overall motor symptoms of PD patients. CONCLUSION Home-based exercise was an effective form of therapy for alleviating motor symptoms. In addition, Mix appeared to be more suitable for PD patients engaging in home-based exercise. Existing evidence suggested that significant therapeutic effects were achieved with a Mix, with a weekly exercise volume exceeding 850 METs and a duration of more than 18 weeks. RELEVANCE TO CLINICAL PRACTICE Home-based exercise had a small effect in relieving overall motor symptoms in PD patients, improving quality of life, walking speed, balance ability and finger dexterity. In terms of exercise dosage, we recommend the exercise period is no less than 18 weeks and the dose per is no less than 850 METs-min. No Patient or Public Contribution.
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Affiliation(s)
- Xianqi Gao
- Department of Nursing Sciences, School of Medicine, Lishui University, Lishui, Zhejiang, China
| | - Haoyang Zhang
- Laboratory of Kinesiology and Rehabilitation, School of Physical Education and Sport, Henan University, Kaifeng, China
| | - Xueying Fu
- Laboratory of Kinesiology and Rehabilitation, School of Physical Education and Sport, Henan University, Kaifeng, China
| | - Yong Yang
- Laboratory of Kinesiology and Rehabilitation, School of Physical Education and Sport, Henan University, Kaifeng, China
- Institute for Brain Sciences Research, School of Life Sciences, Henan University, Kaifeng, China
| | - Jiejie Dou
- Faculty of Teacher Education, Lishui University, Lishui, Zhejiang, China
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Armstrong M, Walters K, Davies N, Nimmons D, Pigott J, Read J, Schrag A. Intervention components in the self-management of Parkinson's: a mixed-methods synthesis of qualitative and quantitative evidence. BMC Health Serv Res 2024; 24:92. [PMID: 38233917 PMCID: PMC10795310 DOI: 10.1186/s12913-023-10436-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 12/05/2023] [Indexed: 01/19/2024] Open
Abstract
INTRODUCTION Self-management interventions consist of multiple components to support people in the management of medical, emotional, and behavioural aspects of their condition, and aim to improve quality of life, function, and other outcomes. A systematic review of self-management interventions in Parkinson's showed no conclusive evidence for effectiveness of specific self-management approaches in Parkinson's to date but identified several potentially useful components. AIM To identify the key required components for self-management in people with Parkinson's by synthesising evidence from a body of primary qualitative evidence and systematic reviews, and to explore which of these key components should be incorporated into trials of self-management in Parkinson's. METHOD A mixed-methods synthesis was conducted. We combined data from two primary qualitative studies and a systematic review of qualitative studies that focused on self-management in Parkinson's to identify key intervention components. These were then mapped onto the results of a systematic review of Randomised Controlled Trials (RCTs) using matrices. First, data were extracted from the qualitative studies with people with Parkinson's and healthcare professionals on the key self-management components in this population. Second, a matrix table was created to map the identified Parkinson's specific self-management components against potential effectiveness from published RCTs of self-management interventions. RESULTS Synthesis of qualitative data identified 15 potential self-management components. These 15 components included components needed to start self-managing (e.g., information, skill acquirement) and components needed to maintain self-managing (e.g., self-motoring, increasing motivation). From 18 RCTs, interventions varied in how many components were included (range 1-10). Trials reporting significant beneficial effects of their intervention included a higher number of components (4 or more self-management components) than trials without significant findings (1-3 self-management components). CONCLUSION Fifteen key self-management components were identified that should be incorporated into interventions or programs of self-management in Parkinson's. No current trial has incorporated all aspects, but a higher number of these key components appears to make trials of self-management interventions more likely to be successful.
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Affiliation(s)
- Megan Armstrong
- Department of Primary Care and Population Health, University College London, Royal Free Campus, Rowland Hill Street, London, NW3 2PF, UK.
| | - Kate Walters
- Department of Primary Care and Population Health, University College London, Royal Free Campus, Rowland Hill Street, London, NW3 2PF, UK
| | - Nathan Davies
- Department of Primary Care and Population Health, University College London, Royal Free Campus, Rowland Hill Street, London, NW3 2PF, UK
| | - Danielle Nimmons
- Department of Primary Care and Population Health, University College London, Royal Free Campus, Rowland Hill Street, London, NW3 2PF, UK
| | - Jennifer Pigott
- Institute of Neurology, University College London, London, UK
| | - Joy Read
- Institute of Neurology, University College London, London, UK
| | - Anette Schrag
- Institute of Neurology, University College London, London, UK
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O’Neil J, Egan M, Marshall S, Bilodeau M, Pelletier L, Sveistrup H. Remotely Supervised Exercise Programmes to Improve Balance, Mobility, and Activity Among People with Moderate to Severe Traumatic Brain Injury: Description and Feasibility. Physiother Can 2023; 75:146-155. [PMID: 37736375 PMCID: PMC10510548 DOI: 10.3138/ptc-2021-0039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 06/30/2021] [Accepted: 07/27/2021] [Indexed: 09/23/2023]
Abstract
Purpose Further investigation into the feasibility of using videoconferencing and activity tracking devices to provide high-intensity home-based exercise programmes for people with a moderate or severe traumatic brain injury (TBI) is needed to inform clinical implementation and patient adoption. This study aimed to (1) determine if home-based telerehabilitation exercise programmes were feasible for people with a moderate or severe TBI and (2) better understand the lived experience of people with a TBI and their family partners with this programme. Methods A mixed-methods approach consisting of measures of feasibility and semi-structured interviews was used. Five participants with moderate to severe TBI and their family partners completed two high-intensity home-based exercise programmes delivered remotely by a physiotherapist (i.e., daily and weekly). Results Telerehabilitation services in home-based settings were feasible for this population. Adherence and engagement were high. Dyads were satisfied with the use of technology to deliver physiotherapy sessions. Conclusion Telerehabilitation provides a delivery option that allows people with TBI to spend energy on therapy rather than on travelling. A pre-programme training on key components, such as the use of technology, safety precautions, and communication methods, likely improved the overall feasibility. Further research is needed to better understand the effectiveness of such a programme on balance, mobility, and physical activity levels.
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Affiliation(s)
- Jennifer O’Neil
- From the:
Schools of Rehabilitation Sciences and
- Bruyère Research Institute, Ottawa, Ontario, Canada
| | - Mary Egan
- From the:
Schools of Rehabilitation Sciences and
- Bruyère Research Institute, Ottawa, Ontario, Canada
| | - Shawn Marshall
- From the:
Schools of Rehabilitation Sciences and
- Bruyère Research Institute, Ottawa, Ontario, Canada
- Physical Medicine and Rehabilitation, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Martin Bilodeau
- From the:
Schools of Rehabilitation Sciences and
- Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
- Bruyère Research Institute, Ottawa, Ontario, Canada
| | - Luc Pelletier
- School of Psychology, Faculty of Social Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Heidi Sveistrup
- From the:
Schools of Rehabilitation Sciences and
- Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
- Bruyère Research Institute, Ottawa, Ontario, Canada
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Alyami HH, Al-Hariri MT. Synergistic Effects of Nigella sativa and Exercise on Diabetic Profiles: A Systematic Review. Diabetes Ther 2023; 14:467-478. [PMID: 36645572 PMCID: PMC9841958 DOI: 10.1007/s13300-022-01362-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 12/23/2022] [Indexed: 01/17/2023] Open
Abstract
Individually, Nigella sativa (NS) and physical training interventions have been shown to be effective preventive and therapeutic strategies for diabetes mellitus. However, the effect of these in combination on bioindicators of diabetes has not yet been evaluated; there is little information available in the literature. A systematic review was therefore performed to assess any mutually potentiating impacts of NS and physical training interventions in diabetic subjects. A search was performed on this topic in the PubMed, CINAHL, Google Scholar and Web of Science databases for randomised, quasi-randomised or non-randomised controlled trials, studies with factorial or single-cohort pre-post designs, case series as well as case reports. The search terms encompassed various combinations of the following: "exercise", "training", "physical activity", "NS", "treadmill", "swimming", "Thymoquinone", "Nigellone", "caraway oil" and "black seeds". Two reviewers screened the abstracts of 202 identified publications according to predetermined inclusion criteria-i.e. papers published from 2009 onwards in the English language, studies on human or animal subjects, and the assessment of diabetic bioindicators following the combined administration of NS and exercise regimens in comparison with just one of these interventions or against controls. Despite the rich data available regarding the effect of both interventions separately, two human studies and two animal studies were ultimately included in the review. However, the benefit of combined administration of NS and exercise regimens on glycemic and lipidemic control was much more obvious compared to exercise alone. In conclusion, these findings suggested that combined administration of NS and exercise regimens could be used as an effective adjuvant for oral antidiabetic drugs in diabetes control.
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Affiliation(s)
- Hiedar H Alyami
- Department of Physiology, College of Medicine, Imam Abdulrahman Bin Faisal University, P.O. Box 2114, Dammam, 31541, Saudi Arabia.
| | - Mohammed T Al-Hariri
- Department of Physiology, College of Medicine, Imam Abdulrahman Bin Faisal University, P.O. Box 2114, Dammam, 31541, Saudi Arabia
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Wang LL, Sun CJ, Wang Y, Zhan TT, Yuan J, Niu CY, Yang J, Huang S, Cheng L. Effects of dance therapy on non-motor symptoms in patients with Parkinson's disease: a systematic review and meta-analysis. Aging Clin Exp Res 2022; 34:1201-1208. [PMID: 35091970 DOI: 10.1007/s40520-021-02030-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Accepted: 11/09/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND Parkinson's disease (PD) represents the second most common neurodegenerative disease. OBJECTIVE To evaluate the effects of dance therapy (DT) aimed at improving non-motor symptoms in PD. METHODS Studies were performed through PubMed, Web of Science, The Cochrane Library, Embase, and Science Direct from inception to October 27, 2021. The data were screened independently by two reviewers, and the quality of the papers was assessed using the Cochrane manual. The included studies were randomized controlled trials and quasi-randomized controlled trials, reporting random-effects standardized mean differences, and 95% confidence intervals as the effect size. I2 statistics were used to assess heterogeneity. The main outcomes included the Montreal Cognitive Assessment Scale (MOCA), Baker Depression Scale (BDI), Parkinson's Fatigue Scale (FPS-16), and Apathy Scale (AS). RevMan 5.3 software was integrated for meta-analysis. RESULTS Nine literatures were analyzed for the meta-analysis with a total of 307 patients. Random effects showed that DT significantly improved cognitive of PD (MD = 1.50, 95% CI [0.52, 2.48], P = 0.0003; I2 = 51%). However, this meta-analysis demonstrated that dance therapy had no significance for improving depression (MD = - 1.33, 95% CI [- 4.11, 1.45], P = 0.35; I2 = 79%), fatigue (MD = 0.26, 95% CI [- 0.31, 0.83], P = 0.37; I2 = 0%), and apathy (MD = 0.07, 95% CI [- 2.55, 2.69], P = 0.96; I2 = 50%). CONCLUSION The meta-analysis suggests that dance can improve cognitive function in PD.
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Affiliation(s)
- Li-Li Wang
- School of Nursing, Anhui University of Chinese Medicine, No. 103 Meishan Street, Hefei, 230031, Anhui, China
| | - Cai-Jie Sun
- School of Nursing, Anhui University of Chinese Medicine, No. 103 Meishan Street, Hefei, 230031, Anhui, China
| | - Yan Wang
- School of Nursing, Anhui University of Chinese Medicine, No. 103 Meishan Street, Hefei, 230031, Anhui, China
| | - Ting-Ting Zhan
- Department of Brain Center, The First Affiliated Hospital of Anhui University of Chinese Medicine, No. 117 Meishan Street, Hefei, 230031, Anhui, China.
| | - Juan Yuan
- School of Nursing, Anhui University of Chinese Medicine, No. 103 Meishan Street, Hefei, 230031, Anhui, China
| | - Cong-Ying Niu
- School of Nursing, Anhui University of Chinese Medicine, No. 103 Meishan Street, Hefei, 230031, Anhui, China
| | - Jie Yang
- School of Nursing, Anhui University of Chinese Medicine, No. 103 Meishan Street, Hefei, 230031, Anhui, China
| | - Shan Huang
- School of Nursing, Anhui University of Chinese Medicine, No. 103 Meishan Street, Hefei, 230031, Anhui, China
| | - Ling Cheng
- School of Humanities and International Educational Exchange, Anhui University of Chinese Medicine, No. 103 Meishan Street, Hefei, 230031, Anhui, China
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Zare M, Özdemir H, Tavşan MY, Tuna F, Süt N, Güler S, Kabayel DD. Effect of Activity-Based Training Versus Strengthening Exercises on Upper Extremity Functions in Parkinson's Patients; A Randomized Controlled, Single Blind, Superiority Trial. Clin Neurol Neurosurg 2022; 218:107261. [DOI: 10.1016/j.clineuro.2022.107261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 03/19/2022] [Accepted: 04/06/2022] [Indexed: 11/16/2022]
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Pigott JS, Kane EJ, Ambler G, Walters K, Schrag A. Systematic review and meta-analysis of clinical effectiveness of self-management interventions in Parkinson's disease. BMC Geriatr 2022; 22:45. [PMID: 35016613 PMCID: PMC8753859 DOI: 10.1186/s12877-021-02656-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 11/23/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Parkinson's disease is a complex neurodegenerative condition with significant impact on quality of life (QoL), wellbeing and function. The objective of this review is to evaluate the clinical effectiveness of self-management interventions for people with Parkinson's disease, taking a broad view of self-management and considering effects on QoL, wellbeing and function. METHODS Systematic searches of four databases (MEDLINE, Embase, PsycINFO, Web of Science) were conducted for studies evaluating self-management interventions for people with Parkinson's disease published up to 16th November 2020. Original quantitative studies of adults with idiopathic Parkinson's disease were included, whilst studies of atypical Parkinsonism were excluded. Full-text articles were independently assessed by two reviewers, with data extracted by one reviewer and reliability checked by a second reviewer, then synthesised through a narrative approach and, for sufficiently similar studies, a meta-analysis of effect size was conducted (using a random-effects meta-analysis with restricted maximum likelihood method pooled estimate). Interventions were subdivided into self-management components according to PRISMS Taxonomy. Risk of bias was examined with the Cochrane Risk of Bias 2 (RoB2) tool or ROBIN-I tool as appropriate. RESULTS Thirty-six studies were included, evaluating a diverse array of interventions and encompassing a range of study designs (RCT n = 19; non-randomised CT n = five; within subject pre- and post-intervention comparisons n = 12). A total of 2884 participants were assessed in studies across ten countries, with greatest output from North America (14 studies) and UK (six studies). Risk of bias was moderate to high for the majority of studies, mostly due to lack of participant blinding, which is not often practical for interventions of this nature. Only four studies reported statistically significant improvements in QoL, wellbeing or functional outcomes for the intervention compared to controls. These interventions were group-based self-management education and training programmes, either alone, combined with multi-disciplinary rehabilitation, or combined with Cognitive Behaviour Therapy; and a self-guided community-based exercise programme. Four of the RCTs evaluated sufficiently similar interventions and outcomes for meta-analysis: these were studies of self-management education and training programmes evaluating QoL (n = 478). Meta-analysis demonstrated no significant difference between the self-management and the control groups with a standardised mean difference (Hedges g) of - 0.17 (- 0.56, 0.21) p = 0.38. By the GRADE approach, the quality of this evidence was deemed "very low" and the effect of the intervention is therefore uncertain. Components more frequently observed in effective interventions, as per PRISMS taxonomy analysis, were: information about resources; training or rehearsing psychological strategies; social support; and lifestyle advice and support. The applicability of these findings is weakened by the ambiguous and at times overlapping nature of self-management components. CONCLUSION Approaches and outcomes to self-management interventions in Parkinson's disease are heterogenous. There are insufficient high quality RCTs in this field to show effectiveness of self-management interventions in Parkinson's disease. Whilst it is not possible to draw conclusions on specific intervention components that convey effectiveness, there are promising findings from some studies, which could be targeted in future evaluations.
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Affiliation(s)
- Jennifer S Pigott
- Queen Square Institute of Neurology, University College London, London, UK
| | - Edward J Kane
- South London & Maudsley NHS Foundation Trust, London, UK
| | - Gareth Ambler
- Department of Statistical Science, University College London, London, UK
| | - Kate Walters
- Centre for Ageing Population Studies, Research Department of Primary Care and Population Health, University College London, London, UK
| | - Anette Schrag
- Queen Square Institute of Neurology, University College London, London, UK.
- UCL Institute of Neurology, Royal Free Campus, University College London, London, NW3 2PF, UK.
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Can a targeted home-based exercise programme improve turning characteristics in individuals with Parkinson's disease? Clin Biomech (Bristol, Avon) 2021; 89:105469. [PMID: 34474314 DOI: 10.1016/j.clinbiomech.2021.105469] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 07/22/2021] [Accepted: 08/24/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Turns are often cited as a difficult task for individuals with Parkinson's disease and often lead to falls, however targeted exercise interventions may help to reduce this problem. This study examined the effects of a 10-week home-based exercise program focusing on turns which may be an exercise approach for improving mobility and reducing falls in individuals with Parkinson's disease. METHODS Turning and stepping characteristics were recorded using Inertial Measurement Units while participants performed a 180° standing turn. Eye movements were measured using a BlueGain electrooculography system. Clinical outcomes were assessed using the Movement Disorders Society-Unified Parkinson's Disease Rating Scale, Functional axial rotation-physical score and the Falls Efficacy Scale International. FINDINGS Twenty individuals with Parkinson's disease were matched by severity using the Modified Hoehn and Yahr scale and were randomly allocated to an exercise (n = 10) or control group (n = 10). Significant improvements were seen after 10 weeks in the exercise group only for; onset latency of body segments, step size, number of fast phase eye movements, the Movement Disorders Society-Unified Parkinson's Disease Rating Scale in motor and rigidity scores, Functional axial rotation-physical score and the Falls Efficacy Scale International. INTERPRETATION These results indicate that the home-based exercise programme targeting turning characteristics had positive effects on turning performance and clinical outcomes associated with falls in individuals with Parkinson's disease. These preliminary results support the notion that targeted home-based exercises may provide an effective intervention in this population.
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The Effects of a 10-Week Home-Based Exercise Programme in Individuals with Parkinson’s Disease during the COVID-19 Pandemic: A Pilot Study. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11104518] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Current restrictions on clinical visits as a consequence of the COVID-19 pandemic has increased the need for home-based exercise regimes to facilitate useful, long term patterns of behaviour in individuals with Parkinson’s disease (PD). This study aimed to evaluate the effectiveness of a 10-week home-based exercise program designed to target improvements in axial rigidity and gait. The Movement Disorders Society-Unified Parkinson’s Disease Rating Scale (MDS-UPDRS), motor scale and rigidity items, Functional axial rotation–physical (FAR-p), functional reach test (FRT), and time up and go (TUG) test were recorded. In addition, the 10-metre walk test, the fall efficacy scale international (FES-I) and the global rating of change score (GROC) were also recorded. Eighteen individuals were divided randomly into two groups: a home-based exercise group (n = 10) and a traditional physiotherapy control group (n = 8). Participants in the 10-week home-based exercise group showed significant improvements (p < 0.05) in the MDS-UPDRS rigidity item, FAR-p, step length, gait velocity, FRT and FES-I when compared with the control group. This study supports the use of home-based exercises in individuals with PD. These preliminary results also support the hypothesis that targeting axial deficits may be an effective approach for improving gait and reducing falls.
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Effects of Balance Training on Nonmotor Symptoms in Individuals With Parkinson Disease. TOPICS IN GERIATRIC REHABILITATION 2020. [DOI: 10.1097/tgr.0000000000000279] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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12
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Swink LA, Fruhauf CA, Atler KE, Fling BW, Klinedinst TC, Schmid AA. Health-related quality of life changes after the merging yoga and occupational therapy for Parkinson's disease program: A mixed-methods study. Complement Ther Clin Pract 2020; 39:101156. [PMID: 32379684 DOI: 10.1016/j.ctcp.2020.101156] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 03/02/2020] [Accepted: 03/23/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND To understand changes in health-related quality of life (HRQoL) after the Merging Yoga and Occupational Therapy for Parkinson's Disease (MY-OT for PD) program. MATERIALS AND METHODS We used a mixed-methods convergent design and administered the Parkinson's Disease Questionnaire-8 (PDQ-8), a measure of HRQoL, with 17 participants. We considered scores 8 weeks before MY-OT for PD, just before, and upon completion. Additionally, we completed two focus groups following the program with 16 participants to assess qualitative changes in HRQoL. RESULTS There were no significant differences in PDQ-8 scores between time points, F(2,32) = 1.60, p = 0.22, partial η2 = 0.09. Participants did discuss improvements in all 8 HRQoL domains, frequently regarding mobility and activities of daily living. CONCLUSION Results diverged, with quantitative results showing no significant improvement in HRQoL and qualitative results indicating participant perceived improvements in all domains of the PDQ-8. The program should be explored further, and longitudinal follow-up completed.
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Affiliation(s)
- Laura A Swink
- Eastern Colorado Veterans Administration, Geriatric Research, Education, and Clinical Center, 80045, USA.
| | - Christine A Fruhauf
- Department of Human Development and Family Studies, Colorado State University, 80523, USA
| | - Karen E Atler
- Department of Occupational Therapy, Colorado State University, 80523, USA
| | - Brett W Fling
- Department of Health and Exercise Science, Colorado State University, 80523, USA; Molecular, Cellular, and Integrative Neuroscience Graduate Program, Colorado State University, 80523, USA
| | - Tara C Klinedinst
- Department of Occupational Therapy, University of Pittsburgh, 15260, USA
| | - Arlene A Schmid
- Department of Occupational Therapy, Colorado State University, 80523, USA
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Flynn A, Allen NE, Dennis S, Canning CG, Preston E. Home-based prescribed exercise improves balance-related activities in people with Parkinson's disease and has benefits similar to centre-based exercise: a systematic review. J Physiother 2019; 65:189-199. [PMID: 31521554 DOI: 10.1016/j.jphys.2019.08.003] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Accepted: 08/13/2019] [Indexed: 12/27/2022] Open
Abstract
QUESTIONS In people with Parkinson's disease, does home-based prescribed exercise improve balance-related activities and quality of life compared with no intervention? Are the effects of home-based exercise similar to those of equivalent centre-based exercise? DESIGN Systematic review and meta-analysis of randomised and quasi-randomised controlled trials. PARTICIPANTS Adults diagnosed with idiopathic Parkinson's disease. INTERVENTION Predominantly home-based prescribed exercise (defined as a minimum of two-thirds of the exercise being completed at home). The intervention had to primarily involve physical practice of exercises targeting gait and/or standing balance compared with either control (ie, usual care only, a sham intervention or no physiotherapy) or equivalent predominantly centre-based exercise. OUTCOME MEASURES The primary outcome was balance-related activities and the secondary outcomes were gait speed, Berg Balance Scale, Functional Reach test, and quality of life. RESULTS Sixteen trials met the inclusion criteria and all contributed to the meta-analyses. Twelve trials compared home-based prescribed exercise with control, and four trials compared home-based prescribed exercise with equivalent centre-based exercise. Home-based prescribed exercise improved balance-related activities (SMD 0.21, 95% CI 0.10 to 0.32) and gait speed (SMD 0.30, 95% CI 0.12 to 0.49), but not quality of life (SMD 0.11, 95% CI -0.01 to 0.23) compared with control. Home-based and centre-based exercise had similar effects on balance-related activities (SMD -0.04, 95% CI -0.36 to 0.27) and quality of life (SMD -0.08, 95% CI -0.41 to 0.24). CONCLUSION Home-based prescribed exercise improves balance-related activities and gait speed in people with Parkinson's disease, and these improvements are similar to improvements with equivalent centre-based exercise. REGISTRATION PROSPERO CRD 42018107331.
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Affiliation(s)
- Allyson Flynn
- Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney, Australia; Discipline of Physiotherapy, Faculty of Health, University of Canberra, Australia.
| | - Natalie E Allen
- Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney, Australia
| | - Sarah Dennis
- Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney, Australia; South Western Sydney Local Health District, Australia
| | - Colleen G Canning
- Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney, Australia
| | - Elisabeth Preston
- Discipline of Physiotherapy, Faculty of Health, University of Canberra, Australia
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Berardelli I, Belvisi D, Pasquini M, Fabbrini A, Petrini F, Fabbrini G. Treatment of psychiatric disturbances in hypokinetic movement disorders. Expert Rev Neurother 2019; 19:965-981. [PMID: 31241368 DOI: 10.1080/14737175.2019.1636648] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Introduction: We reviewed studies that assessed the treatment of psychiatric disturbances in Parkinson's disease and atypical parkinsonisms. Neuropsychiatric disturbances in these conditions are frequent and have a profound impact on quality of life of patients and of their caregivers. It is therefore important to be familiar with the appropriate pharmacological and non-pharmacological interventions for treating these disorders. Areas covered: The authors searched for papers in English in Pubmed using the following keywords: Parkinson's disease, multiple system atrophy, progressive supranuclear palsy, corticobasal degeneration, Lewy body dementia, depression, apathy, anxiety, fatigue, sleep disorders, obsessive compulsive disorders, psychosis, hallucinations, delusions, impulse control disorders. Expert opinion: In Parkinson's disease, depression may benefit from the optimization of dopaminergic therapy, from the use of antidepressants acting on both the serotoninergic and noradrenergic pathways and from cognitive behavioral therapy. Psychosis in Parkinson's disease may improve with the use of clozapine; the serotonin inverse agonist pimavanserin has been shown to be effective. Treatment of impulse control disorders is primarily based on the removal of dopamine agonists. No controlled studies have investigated the treatment of neuropsychiatric disorders in multiple system atrophy, progressive supranuclear palsy or corticobasal degeneration. Acethylcholinesterase inhibitors may be used to treat hallucinations in Lewy body dementia.
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Affiliation(s)
- Isabella Berardelli
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome , Rome , Italy
| | | | - Massimo Pasquini
- Department of Human Neurosciences, Sapienza University of Rome , Rome , Italy
| | - Andrea Fabbrini
- Department of Human Neurosciences, Sapienza University of Rome , Rome , Italy
| | - Federica Petrini
- Department of Neurosciences and Mental Health, Azienda Universitaria Policlinico Umberto I° , Rome , Italy
| | - Giovanni Fabbrini
- IRCCS Neuromed , Pozzilli , Italy.,Department of Human Neurosciences, Sapienza University of Rome , Rome , Italy
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15
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Ryan M, Eatmon CV, Slevin JT. Drug treatment strategies for depression in Parkinson disease. Expert Opin Pharmacother 2019; 20:1351-1363. [DOI: 10.1080/14656566.2019.1612877] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Melody Ryan
- Department of Pharmacy Practice and Science, University of Kentucky College of Pharmacy, Lexington, KY, USA
| | - Courtney V. Eatmon
- Mental Health Clinical Pharmacy Specialist, Lexington Veterans Affairs Healthcare System, Lexington, KY, USA
| | - John T. Slevin
- Departments of Neurology and Pharmacology and Nutritional Sciences, University of Kentucky College of Medicine, Lexington, KY, USA
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16
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Laurencin C, Thobois S. Malattia di Parkinson e depressione. Neurologia 2019. [DOI: 10.1016/s1634-7072(19)42021-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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de Lira CAB, Taveira HV, Rufo-Tavares W, Amorim ADS, Ferreira LMC, Andrade MS, Vancini RL. Engagement in a Community Physical Activity Program and Its Effects Upon the Health-Related Quality of Life of Elderly People: A Cross-Sectional Study. Value Health Reg Issues 2018; 17:183-188. [PMID: 30419539 DOI: 10.1016/j.vhri.2018.10.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Revised: 07/24/2018] [Accepted: 10/11/2018] [Indexed: 10/27/2022]
Abstract
BACKGROUND Aging is related to an increase in the prevalence of noncommunicable diseases and impairments in health-related quality of life. Physical activity is a nonpharmacological intervention that is known to prevent and manage noncommunicable diseases and improve quality of life. OBJECTIVES To compare the quality of life, as measured by the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36), of elderly participants and nonparticipants in a community physical activity program. METHODS One hundred elderly men and women (age > 60 years) who were either sedentary (sedentary [S] group; n = 50, 30 men) or physically active and attended a community physical activity program (physical activity [PA] group; n = 50, 30 men) took part in the study. All participants completed the SF-36 subscales to assess their quality of life. RESULTS The PA group reported higher values on the functioning capacity and general health perceptions subscales of the SF-36 when compared with the S group. Conversely, scores on the following SF-36 subscales did not differ between the groups: role limitations due to physical problems, pain, vitality, social functioning, role limitations due to emotional problems, and mental health. A ceiling effect was evident in both groups for all SF-36 subscales. CONCLUSIONS The SF-36 subscales were not sufficiently sensitive to detect differences between the S and PA groups (except for functioning capacity and general health perceptions), probably because of ceiling effects.
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Affiliation(s)
- Claudio Andre Barbosa de Lira
- Centro de Educação Física e Desportos, Universidade Federal do Espírito Santo, Vitória, Brazil; Setor de Fisiologia Humana e do Exercício, Faculdade de Educação Física e Dança, Universidade Federal de Goiás, Goiânia, Brazil.
| | - Henrique Viana Taveira
- Centro de Educação Física e Desportos, Universidade Federal do Espírito Santo, Vitória, Brazil; Curso de Educação Física, Faculdade do Futuro, Manhuaçu, Brazil
| | - Weverton Rufo-Tavares
- Centro de Educação Física e Desportos, Universidade Federal do Espírito Santo, Vitória, Brazil
| | | | | | | | - Rodrigo Luiz Vancini
- Centro de Educação Física e Desportos, Universidade Federal do Espírito Santo, Vitória, Brazil
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Cash MF, Ulanowski E, Danzl M. Development of a community-based golf and exercise program for people with Parkinson's disease. Complement Ther Clin Pract 2018; 33:149-155. [PMID: 30396614 DOI: 10.1016/j.ctcp.2018.09.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Accepted: 09/21/2018] [Indexed: 11/26/2022]
Abstract
Individuals with Parkinson's disease (PD) typically display symptoms of rigidity, bradykinesia, and postural instability that can limit participation in recreational activities. The purpose of this clinical report is to describe the development, implementation, and outcomes of a novel and innovative community-based golf and exercise program for individuals with PD. In response to community interest, the program was developed through a unique partnership that blended the expertise of physical therapists and golf professionals. The 6-week program consisted of golf instruction and task-specific exercises. Improvements were noted in seven of eight participants for golf performance (driving distance and club head speed) and quality of life (PD Questionnaire-39) outcome measures. This report describes the design and implementation of a golf and exercise program for people with PD based on community need, evidence, and clinical expertise. Considerations and recommendations for future programs are discussed, such as program length, staffing, volunteers, funding, location, and resources.
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Affiliation(s)
- Megan F Cash
- 4960 Norton Healthcare Blvd. Rehabilitation Services, Norton Healthcare, Louisville, KY, 40241, USA; 2001 Newburg Road, Nolen C. Allen Hall, Physical Therapy Program, School of Movement and Rehabilitation Sciences, College of Health Professions, Bellarmine University, Louisville, KY, 40205, USA.
| | - Elizabeth Ulanowski
- 2001 Newburg Road, Nolen C. Allen Hall, Physical Therapy Program, School of Movement and Rehabilitation Sciences, College of Health Professions, Bellarmine University, Louisville, KY, 40205, USA.
| | - Megan Danzl
- 2001 Newburg Road, Nolen C. Allen Hall, Physical Therapy Program, School of Movement and Rehabilitation Sciences, College of Health Professions, Bellarmine University, Louisville, KY, 40205, USA.
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19
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Exercise Therapy for a Patient With Parkinson Disease and Back Pain: A Case Report. J Chiropr Med 2018; 17:72-74. [PMID: 29628812 DOI: 10.1016/j.jcm.2017.10.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Revised: 10/25/2017] [Accepted: 10/26/2017] [Indexed: 11/21/2022] Open
Abstract
Objective The purpose of this report is to describe an exercise intervention for an elderly patient with Parkinson disease with a chief complaint of lower back pain. Clinical Features The patient was an 85-year-old man who had been diagnosed with Parkinson disease and kyphosis. Back pain was preventing him from carrying out activities of daily living. He was referred for physical therapy for treatment to reduce lower back pain and increase function. An initial examination consisted of testing flexibility and range of motion and administering a pain severity scale and a Lower Extremity Functional Index (LEFI); the patient's initial LEFI score was 14/80. Intervention and Outcome Clinical observation was made during each of the patient's physical therapy sessions. After 5 weeks, the patient's LEFI score improved to 30/80. The patient reported that he had no more reoccurring back pain, was able to move much easier, and was able walk more efficiently and with better posture. Conclusion The patient in this case responded positively to a 5-week course of physical therapy that included exercise therapy. His back pain diminished and his function increased after the course of care.
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20
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Ball AL, de Riesthal M, Steele RD. Exploring Treatment Fidelity in Persons With Aphasia Autonomously Practicing With Computerized Therapy Materials. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2018; 27:454-463. [PMID: 29497755 DOI: 10.1044/2017_ajslp-16-0204] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Accepted: 09/07/2017] [Indexed: 06/08/2023]
Abstract
PURPOSE Current computer technologies permit independent practice for people with cognitive-communicative disorders. Previous research has investigated compliance rates and outcome changes but not treatment fidelity per se during practice. Our aim was to examine adherence to procedures (treatment fidelity) and accuracy while persons with aphasia independently practiced word production using interactive, multimodal, user-controlled, word-level icons on computers. METHOD Four persons with aphasia independently practiced single-word production after stimulation via user-initiated interactions in 3 conditions: (I) auditory stimulus with static representational drawing; (II) auditory stimulus with synchronized articulation video; and (III) users' choice between the 2 prior conditions. Sessions were video-recorded for subsequent analysis, which established emergently refined behavioral taxonomies using an iterative, mixed-methods approach. RESULTS In independent practice, users only sometimes adhere to modeled behaviors, other times improvising novel behaviors. The latter sometimes co-occurred with successful productions. Differences in success rates were noted between Conditions I and II across behaviors with Condition II generally favored. In Condition III, participants tended to choose the stimulus that resulted in highest success rates. CONCLUSIONS During independent practice with technology, persons with aphasia do not necessarily comply with clinicians' practice instructions, and treatment fidelity does not determine success. Autonomy and choice in practice may reveal unanticipated dimensions for computerized aphasia treatment.
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Affiliation(s)
- Angel L Ball
- Department of Clinical Health Sciences, Texas A&M University-Kingsville
| | - Michael de Riesthal
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN
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Gondim ITGDO, Lins CCDSA, Asano NMJ, Asano AGC, Cabral ED, Coriolano MDGWDS. Individualized guidance and telephone monitoring in a self-supervised home-based physiotherapeutic program in Parkinson. FISIOTERAPIA EM MOVIMENTO 2017. [DOI: 10.1590/1980-5918.030.003.ao14] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Introduction: Home therapeutic exercises have been a target of interest in the treatment of the Parkinson's disease (PD). The way that the physical therapist guides and monitors these exercises can impact the success of therapy. Objective: To evaluate the effects of individualized orientation and monitoring by telephone in a self-supervised home therapeutic exercise program on signs and symptoms of PD and quality of life (QoL). Methods: Single-blind randomized clinical trials with 28 people with PD (Hoehn and Yahr 1 to 3). Patients were randomized into two groups: experimental and control. The experimental group had a meeting with individualized guidance about physiotherapy exercises present in a manual, received the manual to guide their activities at home and obtained subsequent weekly monitoring by telephone. The control group received the usual cares by the service. Both were orientated to carry out exercises three times a week during 12 weeks. Was evaluated: (1) activities of daily living (ADL) and motor examination sections of the Unified Parkinson's Disease Rating Scale (UPDRS) and QoL by the Parkinson Disease Questionnaire 39 (PDQ-39). The analysis between groups was performed by the Mann-Whitney test and intragroup through the Wilcoxon (p < 0.05). Results: Significant improvement in ADL (p= 0.001) and motor examination (p= 0.0008) of the UPDRS, PDQ-39 total (p = 0.027) and dimensions mobility (p = 0.027), emotional well-being (p= 0.021) and bodily discomfort (p = 0.027) in the experimental group compared to the control group. Conclusion: The individualized guidance and weekly monitoring by telephone in a self-supervised home therapeutic exercises program promoted positive effects on ADL, motor examination and QoL of people in early stages of PD.
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Wu PL, Lee M, Huang TT. Effectiveness of physical activity on patients with depression and Parkinson's disease: A systematic review. PLoS One 2017; 12:e0181515. [PMID: 28749970 PMCID: PMC5531507 DOI: 10.1371/journal.pone.0181515] [Citation(s) in RCA: 90] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Accepted: 06/25/2017] [Indexed: 12/22/2022] Open
Abstract
Aim In this paper we aimed to systematically review the literature on physical activity’s effect on depressive symptoms in Parkinson disease. Background Depression is a common symptom of Parkinson’s disease and is associated with increased disability, rapid progression of motor symptoms, mortality, and adverse effects on Quality of Life. Design A systematic review of primary research was undertaken and conducted according to the Preferred Reporting Items for Systematic Reviews. Data sources Databases Scopus, Psycho-info, CINAHL, PubMed, and ProQuest Cochrance were searched from January 2006 to June 2017. The language was restricted to English. Review methods Abstracts were screened and reviewed against the eligibility criteria (participants’ mean age were ≥ 60 with PD, PA interventions, depression as one of outcome variables, and Randomized Control Trail or quasi-experimental design). Two reviewers appraised the quality of the data extracted. The modified Jadad scale assessed the quality of the methodology of the published papers. Results The database search yielded 769 abstracts, 11 of which were included in this review and awarded scores ranging from 3 to 8 (Scale scores range from 0 to 8 points, higher scores indicated better quality) by the raters. These 11 studies included 342 patients and executed 17 kinds of physical activity programs. Results of this review show empirical evidence to support the efficacy of physical activity for the population with Parkinson’s disease. Aerobic training exercise significantly improved the participants’ scores on the Unified Parkinson’s Disease Rating Scale, the Beck Depression Inventory, and the Quality of Life of the patients. Qigong improved scores in UPDRS-III and decreased incidences of multiple non-motor symptoms and depression. Furthermore, a balance-training program, such as Tai Chi, can improve postural stability and Quality of Life. Conclusions Physical activity may assuage the degeneration of motor skills and depression as well as increase the Quality of Life of Parkinson’s disease patients, with aerobic training producing the best results. These findings suggest that physical activity, notably aerobic training, could be a good exercise strategy for patients with Parkinson’s disease.
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Affiliation(s)
- Pei-Ling Wu
- Graduate Institute of Clinical Medical Sciences, Nursing, Chang Gung University, Tao-Yuan, Taiwan
| | - Megan Lee
- Department of biochemistry, University of Washington, Seattle, WA, United States of America
| | - Tzu-Ting Huang
- Healthy Aging Research Center School of Nursing, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan
- Department of Neurology (Dementia Center), Chang Gung Memorial Hospital Linkou Medical Center, Tao-Yuan, Taiwan
- * E-mail:
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Ahn S, Chen Y, Bredow T, Cheung C, Yu F. Effects of Non-Pharmacological Treatments on Quality of Life in Parkinson's Disease: A Review. ACTA ACUST UNITED AC 2017; 4. [PMID: 28932811 DOI: 10.13188/2376-922x.1000021] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Parkinson's disease is a neurodegenerative chronic condition with a declining trajectory and lack of a cure, making quality of life an important aspect of care. The purpose of this literature review was to analyze the state-of-the-science on the effects of non-pharmacological treatments on quality of life in person's with Parkinson's disease. Literature search was conducted using keywords in electronic databases up to September 1, 2016 and cross-searching the references of identified articles. Of the 259 articles generated, 26 met the eligibility criteria and were included in this review. The majority of studies (77%) were Level I evidence and 23% Level II evidence. The levels of study quality were: strong (50%), moderate (15%), and weak (35%). The interventions varied across studies with 15 studies evaluating a similar intervention. About 58% of the studies showed that the interventions improved quality of life. In conclusion, a variety of non-pharmacological interventions have been increasingly studied for their effects on quality of life in Parkinson's disease, showing initial promising results. However, most interventions were only examined by a limited number of studies and the minimal and optimal intervention doses needed for improving quality of life are yet unknown.
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Affiliation(s)
- Sangwoo Ahn
- University of Minnesota School of Nursing, Minneapolis, Minnesota
| | - Yan Chen
- Taihe Hospital, Hubei Province, China
| | - Tim Bredow
- Department of Nursing, Bethel University, Arden Hills, MN 55112, USA
| | - Corjena Cheung
- University of Minnesota School of Nursing, Minneapolis, Minnesota
| | - Fang Yu
- University of Minnesota School of Nursing, Minneapolis, Minnesota
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Lauzé M, Daneault JF, Duval C. The Effects of Physical Activity in Parkinson's Disease: A Review. JOURNAL OF PARKINSON'S DISEASE 2016; 6:685-698. [PMID: 27567884 PMCID: PMC5088404 DOI: 10.3233/jpd-160790] [Citation(s) in RCA: 109] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Accepted: 07/10/2016] [Indexed: 01/14/2023]
Abstract
BACKGROUND Physical activity (PA) is increasingly advocated as an adjunct intervention for individuals with Parkinson's disease (PD). However, the specific benefits of PA on the wide variety of impairments observed in patients with PD has yet to be clearly identified. OBJECTIVE Highlight health parameters that are most likely to improve as a result of PA interventions in patients with PD. METHODS We compiled results obtained from studies examining a PA intervention in patients with PD and who provided statistical analyses of their results. 868 outcome measures were extracted from 106 papers published from 1981 to 2015. The results were classified as having a statistically significant positive effect or no effect. Then, outcome measures were grouped into four main categories and further divided into sub-categories. RESULTS Our review shows that PA seems most effective in improving Physical capacities and Physical and cognitive functional capacities. On the other hand, PA seems less efficient at improving Clinical symptoms of PD and Psychosocial aspects of life, with only 50% or less of results reporting positive effects. The impact of PA on Cognitive functions and Depression also appears weaker, but few studies have examined these outcomes. DISCUSSION Our results indicate that PA interventions have a positive impact on physical capacities and functional capacities. However, the effect of PA on symptoms of the disease and psychosocial aspects of life are moderate and show more variability. This review also highlights the need for more research on the effects of PA on cognitive functions, depression as well as specific symptoms of PD.
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Affiliation(s)
- Martine Lauzé
- Département des sciences de l’activité physique, Université du Québec à Montréal, QC, Canada
- Centre de Recherche Institut Universitaire de Gériatrie de Montréal, Montréal, QC, Canada
| | - Jean-Francois Daneault
- Centre de Recherche Institut Universitaire de Gériatrie de Montréal, Montréal, QC, Canada
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, USA
| | - Christian Duval
- Département des sciences de l’activité physique, Université du Québec à Montréal, QC, Canada
- Centre de Recherche Institut Universitaire de Gériatrie de Montréal, Montréal, QC, Canada
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Pokhabov DV, Abramov VG, Pokhabov DD. [Possibilities of non-drug treatment for Parkinson's disease]. Zh Nevrol Psikhiatr Im S S Korsakova 2016; 116:22-29. [PMID: 27635607 DOI: 10.17116/jnevro20161168122-29] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
In this article, non-drug methods of treatment of Parkinson's disease are reviewed. Particular attention is given to the motor symptoms of disease, specifically to gait disorders. Information about objective methods of gait impairment is presented. Own results that confirm the effect of a method of tempo-rhythmical correction of walk in patients with Parkinson's disease (PD) and vascular parkinsonism as well as a device for assessment of gait parameters developed by the authors are analyzed. The efficacy of other methods of gait correction using external cues, study design and level of evidence are analyzed as well. Information about possibilities of physical therapy and ergotherapy for correction of different symptoms of Parkinson's disease is presented. Positive and negative results of transcranial magnetic stimulation, light therapy and transcranial micropolarization in PD are analyzed. Basis non-drug methods of PD treatment, which currently have insufficient level of evidence (methods of mental relaxation and auditory training, methods of whole body vibration (vibromassage), laser therapy (photoacoustic therapy), acupuncture), are described in brief. Perspectives of the method of gait recovery in PD using tempo-rhythmic correction are emphasized.
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Affiliation(s)
- D V Pokhabov
- Voyno-Yasenetsky Krasnoyarsk State Medical University, Krasnoyarsk, Russia; Siberian Research and Clinical Centre, Krasnoyarsk, Russia
| | - V G Abramov
- Voyno-Yasenetsky Krasnoyarsk State Medical University, Krasnoyarsk, Russia; Siberian Research and Clinical Centre, Krasnoyarsk, Russia
| | - D D Pokhabov
- Voyno-Yasenetsky Krasnoyarsk State Medical University, Krasnoyarsk, Russia; Siberian Research and Clinical Centre, Krasnoyarsk, Russia
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Kvam S, Kleppe CL, Nordhus IH, Hovland A. Exercise as a treatment for depression: A meta-analysis. J Affect Disord 2016; 202:67-86. [PMID: 27253219 DOI: 10.1016/j.jad.2016.03.063] [Citation(s) in RCA: 432] [Impact Index Per Article: 54.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Revised: 02/29/2016] [Accepted: 03/12/2016] [Indexed: 01/14/2023]
Abstract
BACKGROUND This meta-analysis of randomized controlled trials (RCTs) examines the efficacy of physical exercise as treatment for unipolar depression, both as an independent intervention and as an adjunct intervention to antidepressant medication. METHODS We searched PsycINFO, EMBASE, MEDLINE, CENTRAL, and Sports Discus for articles published until November 2014. Effect sizes were computed with random effects models. The main outcome was reduction in depressive symptoms or remission. RESULTS A total of 23 RCTs and 977 participants were included. Physical exercise had a moderate to large significant effect on depression compared to control conditions (g=-0.68), but the effect was small and not significant at follow-up (g=-0.22). Exercise compared to no intervention yielded a large and significant effect size (g=-1.24), and exercise had a moderate and significant effect compared to usual care (g=-0.48). The effects of exercise when compared to psychological treatments or antidepressant medication were small and not significant (g=-0.22 and g=-0.08, respectively). Exercise as an adjunct to antidepressant medication yielded a moderate effect (g=-0.50) that trended toward significance. LIMITATIONS Use of the arms with the largest clinical effect instead of largest dose may have overestimated the effect of exercise. CONCLUSIONS Physical exercise is an effective intervention for depression. It also could be a viable adjunct treatment in combination with antidepressants.
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Affiliation(s)
- Siri Kvam
- Sogndal Child and Adolescent Psychiatric Outpatient Clinic, Division of Medicine, District General Hospital of Førde, postboks 1000, 6807 Førde, Norway.
| | | | | | - Anders Hovland
- Department of Clinical Psychology, University of Bergen, Norway; Solli District Psychiatric Centre (DPS), Norway
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Pedersen BK, Saltin B. Exercise as medicine - evidence for prescribing exercise as therapy in 26 different chronic diseases. Scand J Med Sci Sports 2016; 25 Suppl 3:1-72. [PMID: 26606383 DOI: 10.1111/sms.12581] [Citation(s) in RCA: 1624] [Impact Index Per Article: 203.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/16/2015] [Indexed: 12/12/2022]
Abstract
This review provides the reader with the up-to-date evidence-based basis for prescribing exercise as medicine in the treatment of 26 different diseases: psychiatric diseases (depression, anxiety, stress, schizophrenia); neurological diseases (dementia, Parkinson's disease, multiple sclerosis); metabolic diseases (obesity, hyperlipidemia, metabolic syndrome, polycystic ovarian syndrome, type 2 diabetes, type 1 diabetes); cardiovascular diseases (hypertension, coronary heart disease, heart failure, cerebral apoplexy, and claudication intermittent); pulmonary diseases (chronic obstructive pulmonary disease, asthma, cystic fibrosis); musculo-skeletal disorders (osteoarthritis, osteoporosis, back pain, rheumatoid arthritis); and cancer. The effect of exercise therapy on disease pathogenesis and symptoms are given and the possible mechanisms of action are discussed. We have interpreted the scientific literature and for each disease, we provide the reader with our best advice regarding the optimal type and dose for prescription of exercise.
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Affiliation(s)
- B K Pedersen
- The Centre of Inflammation and Metabolism and The Center for Physical Activity Research, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - B Saltin
- The Copenhagen Muscle Research Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
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Gondim ITGDO, Lins CCDSA, Coriolano MDGWDS. Exercícios terapêuticos domiciliares na doença de Parkinson: uma revisão integrativa. REVISTA BRASILEIRA DE GERIATRIA E GERONTOLOGIA 2016. [DOI: 10.1590/1809-98232016019.150040] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumo Exercícios terapêuticos domiciliares vêm assumindo importância em estudos recentes como estratégia do cuidado para o controle de sinais e sintomas da doença de Parkinson (DP). Essa revisão integrativa da literatura objetivou reunir estudos publicados entre o período de 2010 e 2014, disponibilizados em português, inglês ou espanhol sobre a utilização de exercícios terapêuticos domiciliares como estratégia do cuidado fisioterapêutico na DP. Realizou-se levantamento de artigos nas bases de dados LILACS, PEDro, PubMed e Cochrane, mediante as combinações: Fisioterapia AND doença de Parkinson ou Home Exercise AND Parkinson's Disease. Para análise da qualidade metodológica, os instrumentos utilizados foram o Critical Appraisal Skill Programme (CASP) adaptado e o Agency for Healthcare and Research and Quality (AHRQ). Os benefícios da cinesioterapia foram: estímulo ao autocuidado; ganho de força e amplitude de movimento; redução do número de queixas e do medo de cair; melhora de sintomas motores relacionados ao Parkinson e à qualidade de vida. Com relação aos benefícios da reabilitação com realidade virtual houve: melhora na marcha, na capacidade funcional e no equilíbrio, além de boa aceitação e aspecto motivacional.
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Román E, García-Galcerán C, Torrades T, Herrera S, Marín A, Doñate M, Alvarado-Tapias E, Malouf J, Nácher L, Serra-Grima R, Guarner C, Cordoba J, Soriano G. Effects of an Exercise Programme on Functional Capacity, Body Composition and Risk of Falls in Patients with Cirrhosis: A Randomized Clinical Trial. PLoS One 2016; 11:e0151652. [PMID: 27011355 PMCID: PMC4807034 DOI: 10.1371/journal.pone.0151652] [Citation(s) in RCA: 101] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Accepted: 03/02/2016] [Indexed: 12/12/2022] Open
Abstract
UNLABELLED Patients with cirrhosis often have functional limitations, decreased muscle mass, and a high risk of falls. These variables could improve with exercise. The aim was to study the effects of moderate exercise on functional capacity, body composition and risk of falls in patients with cirrhosis. Twenty-three cirrhotic patients were randomized to an exercise programme (n = 14) or to a relaxation programme (n = 9). Both programmes consisted of a one-hour session 3 days a week for 12 weeks. At the beginning and end of the study, we measured functional capacity using the cardiopulmonary exercise test, evaluated body composition using anthropometry and dual energy X-ray absorptiometry, and estimated risk of falls using the Timed Up&Go test. In the exercise group, cardiopulmonary exercise test showed an increase in total effort time (p<0.001) and ventilatory anaerobic threshold time (p = 0.009). Upper thigh circumference increased and mid-arm and mid-thigh skinfold thickness decreased. Dual energy X-ray absorptiometry showed a decrease in fat body mass (-0.94 kg, 95%CI -0.48 to -1.41, p = 0.003) and an increase in lean body mass (1.05 kg, 95%CI 0.27 to 1.82, p = 0.01), lean appendicular mass (0.38 kg, 95%CI 0.06 to 0.69, p = 0.03) and lean leg mass (0.34 kg, 95%CI 0.10 to 0.57, p = 0.02). The Timed Up&Go test decreased at the end of the study compared to baseline (p = 0.02). No changes were observed in the relaxation group. We conclude that a moderate exercise programme in patients with cirrhosis improves functional capacity, increases muscle mass, and decreases body fat and the Timed Up&Go time. TRIAL REGISTRATION ClinicalTrials.gov NCT01447537.
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Affiliation(s)
- Eva Román
- Gastroenterology Department, Institut de Recerca-IIB Sant Pau, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Escola Universitària d’Infermeria EUI Sant Pau, Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain
- CIBERehd, Instituto de Salud Carlos III, Madrid, Spain
| | - Cristina García-Galcerán
- Gastroenterology Department, Institut de Recerca-IIB Sant Pau, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Teresa Torrades
- Physical Medicine and Rehabilitation Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Silvia Herrera
- Internal Medicine Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Ana Marín
- Internal Medicine Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Maite Doñate
- Cardiology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Edilmar Alvarado-Tapias
- Gastroenterology Department, Institut de Recerca-IIB Sant Pau, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Jorge Malouf
- Internal Medicine Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Laura Nácher
- Gastroenterology Department, Institut de Recerca-IIB Sant Pau, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Ricard Serra-Grima
- Cardiology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Carlos Guarner
- Gastroenterology Department, Institut de Recerca-IIB Sant Pau, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain
- CIBERehd, Instituto de Salud Carlos III, Madrid, Spain
| | - Juan Cordoba
- Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain
- CIBERehd, Instituto de Salud Carlos III, Madrid, Spain
- Liver Unit, Internal Medicine Department, Hospital Vall d’Hebron, Barcelona, Spain
| | - German Soriano
- Gastroenterology Department, Institut de Recerca-IIB Sant Pau, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain
- CIBERehd, Instituto de Salud Carlos III, Madrid, Spain
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Kinetic Program and Functional Status in Patients with Parkinson's Disease. CURRENT HEALTH SCIENCES JOURNAL 2016; 42:51-60. [PMID: 30568813 PMCID: PMC6256149 DOI: 10.12865/chsj.42.01.08] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Accepted: 03/16/2016] [Indexed: 11/18/2022]
Abstract
The main purpose of kinetic program integrated in complex medical assistance of PD patients is the improvement of life quality, through amelioration of self-care activities, and possibility of making various activities in stability, balance and coordination conditions. We choose the kinetics techniques according to the clinical form and the gravity of the functional deficit. Taking into consideration the locomotors dysfunctional status, almost patients were included in the second and third evolutional stages. For quantize the results and monitories the patients with assessment of the kinetic program benefits we have use different scales and questionnaires. The age of the patients was over 45 years and more patients were male then women; this aspect confirm the increase frequency of disease in the male subjects. The individual and global clinical motor aspects were been influenced by the kinetic program. The global functional impact upon the individual general state was appreciated with scale FIM scale (Functional Independence Measure). Each patient and the entire studied group had presented an increase of the final motor score; this evolution mode proved the important of the kinetic program in the management of the Parkinsonism patient global state. “The PD patients have not be help” in the quotidian activities performance – is one of the kinetic rules that has be respected by all the family patient members.
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Foster ER, Bedekar M, Tickle-Degnen L. Systematic review of the effectiveness of occupational therapy-related interventions for people with Parkinson's disease. Am J Occup Ther 2014; 68:39-49. [PMID: 24367954 DOI: 10.5014/ajot.2014.008706] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
We describe the results of a systematic review of the literature on occupational therapy-related interventions for people with Parkinson's disease (PD). Three broad categories of intervention emerged: (1) exercise or physical activity; (2) environmental cues, stimuli, and objects; and (3) self-management and cognitive-behavioral strategies. Moderate to strong evidence exists for task-specific benefits of targeted physical activity training on motor performance, postural stability, and balance. Low to moderate evidence indicates that more complex, multimodal activity training supports improvement in functional movement activities. The evidence is moderate that the use of external supports during functional mobility or other movement activities has positive effects on motor control. In addition, moderate evidence is available that individualized interventions focused on promoting participant wellness initiatives and personal control by means of cognitive-behavioral strategies can improve targeted areas of quality of life. The implications for practice, education, and research are discussed.
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Affiliation(s)
- Erin R Foster
- Erin R. Foster, OTD, MSCI, OTR/L, is Assistant Professor, Program in Occupational Therapy, Departments of Neurology and Psychiatry, Washington University School of Medicine, St. Louis, MO
| | - Mayuri Bedekar
- Mayuri Bedekar, MS, OTR/L, is Occupational Therapist, HCR ManorCare, Roselle, IL
| | - Linda Tickle-Degnen
- Linda Tickle-Degnen, PhD, OTR/L, FAOTA, is Professor and Chair, Department of Occupational Therapy, Tufts University, 26 Winthrop Street, Medford, MA 02155;
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Román E, Torrades MT, Nadal MJ, Cárdenas G, Nieto JC, Vidal S, Bascuñana H, Juárez C, Guarner C, Córdoba J, Soriano G. Randomized pilot study: effects of an exercise programme and leucine supplementation in patients with cirrhosis. Dig Dis Sci 2014; 59:1966-75. [PMID: 24599772 DOI: 10.1007/s10620-014-3086-6] [Citation(s) in RCA: 131] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2013] [Accepted: 02/18/2014] [Indexed: 12/25/2022]
Abstract
BACKGROUND Physical exercise could improve functional limitations, muscle mass, and health-related quality of life (HRQoL) in patients with cirrhosis. AIM The purpose of this study was to evaluate the efficacy and safety of an exercise programme and leucine supplementation to increase exercise capacity, muscle mass, and HRQoL in patients with cirrhosis. PATIENTS AND METHODS Seventeen outpatients with cirrhosis were randomized to an exercise group (n = 8) or a control group (n = 9) in a pilot study. The programme of moderate exercise was performed for 12 weeks under supervision of a physiotherapist. All patients received oral leucine (10 g/day) during the study. At baseline and at the end of the study, we determined exercise capacity (6-min walk and 2-min step tests), anthropometric measurements, and HRQoL by Short Form-36 (SF-36) questionnaire. We also analyzed safety regarding complications of cirrhosis, liver and renal function, inflammatory response and oxidative stress. RESULTS In the exercise group, exercise capacity improved, as shown by the increase in the 6-min walk test from 365 (160-420) to 445 m (250-500) (p = 0.01), and in the 2-min step test (p = 0.02). Lower thigh circumference also increased, from 41 (34-53) to 46 cm (36-56) (p = 0.02), and the domains of SF-36 general health (p = 0.03), vitality (p = 0.01) and social function (p = 0.04) improved significantly. In the control group, no statistically significant changes were observed in any of the parameters. We did not observe complications of cirrhosis in either group during the study. CONCLUSIONS A programme of moderate physical exercise together with leucine supplements in patients with cirrhosis is safe and improves exercise capacity, leg muscle mass and HRQoL.
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Affiliation(s)
- Eva Román
- Department of Gastroenterology, Hospital de la Santa Creu i Sant Pau, Mas Casanovas 90, 08041, Barcelona, Spain
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McGill A, Houston S, Lee RYW. Dance for Parkinson's: a new framework for research on its physical, mental, emotional, and social benefits. Complement Ther Med 2014; 22:426-32. [PMID: 24906580 DOI: 10.1016/j.ctim.2014.03.005] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2013] [Revised: 01/20/2014] [Accepted: 03/17/2014] [Indexed: 11/16/2022] Open
Abstract
Parkinson's is a neurodegenerative disease commonly associated with symptoms such as tremor, rigidity, bradykinesia, freezing during gait, motor control deficits and instability. These physical symptoms can cause a myriad of psychological problems including depression, feelings of loneliness, and low self-esteem. Current research suggests pharmacological interventions do not sufficiently address all symptoms and thus alternative therapies have been deemed an important part of treatment for people with Parkinson's. Dance has shown to be a beneficial activity for this population. Upon reviewing recent dance for Parkinson's studies it is clear that there are developing trends with respect to overall approach. The tendency to place more emphasis on changes to clinical signs is creating a gap whereby research neglects to look at how dance is influencing a particular individual in all aspects of their life. There is a need for a framework that allows for and encourages the analysis of the dancing experience for people with Parkinson's on a variety of levels including physically, mentally, emotionally, and socially. With such a framework it would be possible to triangulate the information gathered to draw stronger conclusions that are more meaningful to the people with Parkinson's. This paper would like to propose the use of the World Health Organization's International Classification of Functioning, Disability, and Health as a possible framework for dance for Parkinson's research.
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Affiliation(s)
- Ashley McGill
- Department of Dance, University of Roehampton, London, UK; Department of Life Sciences, University of Roehampton, London, UK.
| | - Sara Houston
- Department of Dance, University of Roehampton, London, UK; Department of Life Sciences, University of Roehampton, London, UK
| | - Raymond Y W Lee
- Department of Dance, University of Roehampton, London, UK; Department of Life Sciences, University of Roehampton, London, UK
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Chen JJ, Marsh L. Depression in Parkinson's disease: identification and management. Pharmacotherapy 2013; 33:972-83. [PMID: 23798003 DOI: 10.1002/phar.1314] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Depression is a common psychiatric comorbidity in Parkinson's disease (PD) and contributes to significant impairments in cognitive, functional, motor, and social performance. This results in reduced quality of life, higher levels of care dependency, and increased caregiver burden. When treating depression, it is important to ensure that the patient's response to treatment will be adequately monitored. This can be accomplished in neurology or primary care settings, or in clinical settings with interdisciplinary treatment teams. Mental health services should be engaged early as a component of ongoing comprehensive care. This article reviews a general approach to treating the pharmacotherapy of depression in PD. Ultimately, clinicians should rely on empiric assessments of known risks and putative benefits to guide treatment decisions and should include a targeted and individualized multimodal approach that utilizes psychotherapeutic interventions along with pharmacologic therapies.
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Affiliation(s)
- Jack J Chen
- Schools of Medicine and Pharmacy, Loma Linda University, Loma Linda, California
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Garcia Vazquez C, Moreno Martinez E, Valero Duboy M, Gomez Oliva A. Distributed System for Cognitive Stimulation Over Interactive TV. ACTA ACUST UNITED AC 2012; 16:1115-21. [DOI: 10.1109/titb.2012.2220782] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Feasibility of 2 Different Water-Based Exercise Training Programs in Patients With Parkinson's Disease: A Pilot Study. Arch Phys Med Rehabil 2012; 93:1709-14. [DOI: 10.1016/j.apmr.2012.03.029] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2012] [Revised: 03/21/2012] [Accepted: 03/26/2012] [Indexed: 11/20/2022]
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Georgy E, Barsnley S, Chellappa R. Effect of physical exercise-movement strategies programme on mobility, falls, and quality of life in Parkinson's disease. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2012. [DOI: 10.12968/ijtr.2012.19.2.88] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Ehab Georgy
- NHS Suffolk, Suffolk Community Healthcare, UK
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Allen NE, Sherrington C, Suriyarachchi GD, Paul SS, Song J, Canning CG. Exercise and motor training in people with Parkinson's disease: a systematic review of participant characteristics, intervention delivery, retention rates, adherence, and adverse events in clinical trials. PARKINSON'S DISEASE 2011; 2012:854328. [PMID: 22191077 PMCID: PMC3236465 DOI: 10.1155/2012/854328] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/13/2011] [Accepted: 08/18/2011] [Indexed: 01/29/2023]
Abstract
There is research evidence that exercise and motor training are beneficial for people with Parkinson's disease (PD), and clinicians seek to implement optimal programs. This paper summarizes important factors about the nature and reporting of randomized controlled trials of exercise and/or motor training for people with PD which are likely to influence the translation of research into clinical practice. Searches identified 53 relevant trials with 90 interventions conducted for an average duration of 8.3 (SD 4.2) weeks. Most interventions were fully supervised (74%) and conducted at a facility (79%). Retention rates were high with 69% of interventions retaining ≥85% of their participants; however adherence was infrequently reported, and 72% of trials did not report adverse events. Overall, the labor-intensive nature of most interventions tested in these trials and the sparse reporting of adherence and adverse events are likely to pose difficulties for therapists attempting to balance benefits and costs when selecting protocols that translate to sustainable clinical practice for people with PD.
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Affiliation(s)
- Natalie E. Allen
- Clinical and Rehabilitation Research Group, Faculty of Health Sciences, The University of Sydney, P.O. Box 170, Lidcombe, Sydney, NSW 1825, Australia
| | - Catherine Sherrington
- Musculoskeletal Division, The George Institute for Global Health, The University of Sydney, Sydney, NSW 2050, Australia
| | - Gayanthi D. Suriyarachchi
- Clinical and Rehabilitation Research Group, Faculty of Health Sciences, The University of Sydney, P.O. Box 170, Lidcombe, Sydney, NSW 1825, Australia
| | - Serene S. Paul
- Clinical and Rehabilitation Research Group, Faculty of Health Sciences, The University of Sydney, P.O. Box 170, Lidcombe, Sydney, NSW 1825, Australia
| | - Jooeun Song
- Clinical and Rehabilitation Research Group, Faculty of Health Sciences, The University of Sydney, P.O. Box 170, Lidcombe, Sydney, NSW 1825, Australia
| | - Colleen G. Canning
- Clinical and Rehabilitation Research Group, Faculty of Health Sciences, The University of Sydney, P.O. Box 170, Lidcombe, Sydney, NSW 1825, Australia
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Winward C, Sackley C, Meek C, Izadi H, Barker K, Wade D, Dawes H. Weekly exercise does not improve fatigue levels in Parkinson's disease. Mov Disord 2011; 27:143-6. [PMID: 21953509 DOI: 10.1002/mds.23966] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2011] [Revised: 08/07/2011] [Accepted: 08/29/2011] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Fatigue is one of the most disabling non-motor symptoms for people with Parkinson's disease. Exercise may modify fatigue. This study examines prescribed exercise effects on physical activity levels, well-being, and fatigue in Parkinson's disease. METHODS In this single-blinded trial, participants were randomly assigned to either a 12 week community exercise program or control group. Primary outcome measures were fatigue (Fatigue Severity Scale) and physical activity. RESULTS Thirty-nine people with Parkinson's disease were included: 20 in exercise and 19 in control. Sixty-five percent of the study group were fatigued (n = 24, mean 4.02, SD 1.48). Increased fatigue was associated with lower mobility and activity (P < .05). Individuals participated in a mean of 15 (SD 10) exercise sessions with no significant change in fatigue, mobility, well-being, or physical activity after exercise (P ≥ .05). CONCLUSION Participation in weekly exercise did not improve fatigue in people with Parkinson's Disease.
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Affiliation(s)
- Charlotte Winward
- Movement Science Group, School of Life Sciences, Oxford Brookes University, Oxford, UK.
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Ransmayr G. Physical, occupational, speech and swallowing therapies and physical exercise in Parkinson's disease. J Neural Transm (Vienna) 2011; 118:773-81. [PMID: 21461962 DOI: 10.1007/s00702-011-0622-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2010] [Accepted: 02/22/2011] [Indexed: 12/25/2022]
Abstract
Former studies on the effects of physical exercise, physical and occupational therapy (PT, OT) and speech and swallowing therapy (ST, SwT) in Parkinson's disease (PD) have demonstrated little or uncertain effects. New pathophysiological concepts have been developed. Recent controlled high-level studies demonstrate improvement of mobility and balance after training of muscular strength and endurance, trunk control, and amplitude and rhythmicity of movements (treadmill). Attentional and cognitive strategies were found to enforce body awareness and improve movement sequences. Dance, sensory (auditory, visual, tactile) and cognitive cueing are effective for problems of gait and balance. Whether PT and OT reduce the risk of falls remains uncertain. ST including Lee Silverman Voice Treatment has been shown to relieve speech problems. SwT and OT are frequently applied, however, further studies are necessary. Therapeutic interventions need to be evaluated with regard to consistency, intensity, frequency, duration, side effects, home versus institution based and standardized versus individualized training, quality standards, practicability in real life, and cost-effectiveness. Parkinson patients should resume or continue physical exercise as long as possible. There is hope that regular sport may modify PD risk and progression.
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Affiliation(s)
- G Ransmayr
- Department of Neurology and Psychiatry, General Hospital of the City of Linz, Linz, Austria.
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